Table 3.
Treatment regimens and outcomes of patients who developed pulmonary NTM disease during biological therapy for RA
| Case no. | Treatment of NTM disease (duration)a | RA therapy after NTM development | Cultures | Radiology | RA control |
|---|---|---|---|---|---|
| 1 | CAM, RFP, EB (16 m) | MTX, BUC | Negative | Improved | Well |
| 2 | None (19 m) | TAC, PSL | No change | No change | Well |
| 3 | CAM, RFP, EB (13 m) → none (15 m) | PSL (5 m) → TCZ, PSL | Negative | Improved | Exacerbated → well |
| 4 | None (3 years) | SASP, PSL | No change | No change | Exacerbated |
| 5 | CAM, RFP, EB, SM (20 m) | None | Negative | Improved | ND |
| 6 | CAM (12 m) → none (6 years) | MTX, BUC | Negative | Improved | Exacerbated |
| 7 | CAM, RFP, EB, SM (5 m) | MTX, PSL | Negative | Improved | Exacerbated |
| 8 | CAM, RFP, EB (18 m) | None | Negative | Improved | Well |
| 9 | CAM, RFP, EB (3 m) → AZM (3 m) | PSL | Negative | Improved | Well |
| 10 | CAM, RFP, EB (1 m) → CAM, EB (14 m) | MTX, SASP, PSL | Negative | Improved | Exacerbated |
| 11 | None (14 m) → CAM, RFP, EB, LVFX (2 years) | ETN, MTX, SASP, PSL (13 m) → MTX, SASP, PSL | Negative | Improved | Well → exacerbated |
| 12 | RFP, EB, MFLX (22 m) | BUC, PSL | Negative | Improved | Exacerbated |
| 13 | CAM, EB, LVFX (20 m) | MTX, TAC, PSL | Negative | Improved | Well |
NTM nontuberculous mycobacteria, RA rheumatoid arthritis, CAM clarithromycin, AZM azithromycin, RFP rifampicin, RBT rifabutin, EB ethambutol, SM streptomycin, MFLX moxifloxacin, LVFX levofloxacin, MTX methotrexate, BUC bucillamine, SASP salazosulfapyridine, TAC tacrolimus, TCZ tocilizumab, ETN etanercept, PSL prednisolone, ND no data, m months
aIn cases 3 and 6, anti-NTM therapy was completed; cases 2 and 4 had never received such therapy; and the other patients were still receiving anti-NTM agents at the time of enrollment in this study. Side effects of anti-NTM agents were observed in case 9 (hepatotoxicity) and case 10 (eruption)